Early in December I was putting out the garbage — barefoot, of course — and the pinky toe on my right foot caught on one of the driveway cobblestones. (Another one of my crazy, wacko injuries like my self-inflicted black eye and toddler-induced cut finger.) With blood pouring out, I hobbled inside, wrapped the wound, and got my little one ready for school. After dropping her off, I went over to a local podiatrist to get it checked out. I figured I would be getting at least a stitch or two.
I was lucky. After the doctor cleaned the wound and cut back some of my toenail she told me that it was probably broken (of course) and that although it was still bleeding a lot, the bleeding would stop within a few hours. She bandaged it up, and was about to send me on my way when she asked how I had found out about her office. I told her that I walked around on her practice for more than a decade. I wasn’t kidding. I have orthotics and they are printed with her practice’s name and number. How old were my orthotics really, she wanted to know. Old, I said. I had them for at least 15 years. That’s when she told me that orthotics have a “shelf life” of a couple of years. She told me I should replace the ones I had, and suggested that I do it when I followed up with her in a week for a pinky toe recheck. Why not, I figured.
The next Saturday I went back to the foot care practice. The doctor checked out my black and still-painful toe, and then told me that her office had checked and my orthotics would be covered 100 percent. If I wanted them, they could do the exam right then and there. The kids were at their Saturday morning events, so I jumped at the chance. Oh, there would be just one thing, her assistant added. I had to get x-rays because, and I quote, “it is a requirement of your insurance carrier.” Hmmm. I was skeptical, but I figured that a doctor’s office — my doctor’s office — wouldn’t lie to me. Soon after I found myself standing on an x-ray platform. A week or so later I got the detailed bill from the insurance company. My re-check, x-rays, and orthotics cost my insurance company $960. An hour-long visit netted the practice almost $1,000 once they threw in my $20 co-pay.
Okay, so earlier this week I get a call from the podiatrist’s office. My orthotics were in, and the woman on the phone wanted to set up an office visit to have me pick them up. I’ve worn orthotics for years, I explained, I don’t need or want an office visit. And then came more or less the exact words the doctor’s assistant had said at my first visit: “Your insurance company requires an office visit before we can give them to you.”
I had my in-laws here when they called, so I didn’t want to argue on the phone. However, this time, I wasn’t just taking their word for it. And so earlier today I put in a call to my insurance company. Guess what? Not only were they lying about the office visit, but I didn’t need x-rays, either. I was mad.
I called the office and spoke to the receptionist. I wanted to come pick up my orthotics, please, I said. She reiterated her “insurance requires it” speech, and said the doctor had to “put the orthotics” in my shoes. I didn’t even let her finish before letting her know that I knew she was being less than truthful with me. I told her I had just gotten off the phone with the insurance company, and there was no such rule. Finally, I told her that I was not wasting $35 (my co-pay went up this year) to have a doctor slide inserts into my shoes. She was quiet for a second before taking my number and saying she would have to “check” with the office manager first. And now I’m waiting to hear back.
This is another example of why I feel like we all have to be our own medical advocates. The Republicans and Democrats can bitch all they want about class warfare, but the real battle is happening in doctor, dentist, and therapist offices across the country. Payments have gone down, paperwork has gone up, and we are bearing the brunt of both. We get tests we don’t need so doctors can boost their per-office visit fees. We wait for HOURS because they rack ‘em and stack ‘em, piling up patients so they don’t have any downtime in case someone should cancel. They charge us for copies of our medical records, something that should essentially be free since we OWN them. They spend less and less time with us and get mad if we ask questions. (Exhibit A: The midwife who told me, after my miscarriage, that her office might not be for me since I dared to question her treatment plan.)
People, we are the only ones who can mitigate these issues. We MUST be vigilant so we get the best care at the most reasonable charges. We have to stop blindly taking medicines, submitting to testing, and filling out paperwork. (For example, you shouldn’t give your Social Security number to your doctor’s office unless you’re receiving Medicare or Medicaid.) We have to be willing to question why, and if we’re not satisfied with the answer, we have to keep asking — and in some cases someone else — until we are. Whew. I hate being all soapbox-y, but this stuff really, really makes me crazy.
I cannot WAIT to see what happens with my podiatrist, one who was recently given a Best Of award by a local newspaper. Will they hold my orthotics hostage? Will they waive my co-pay just so they can bill my insurance company? I’ll let you know.